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Hemolytic Anemias Introduction


Normal red cells have a life span of about 120 days

All hemolytic anemias are characterized by
     (1) an increased rate of red cell destruction
     (2) a compensatory increase in erythropoietin levels and erythropoiesis that            results in reticulocytosis
     (3) associated with a marked erythroid hyperplasia within the marrow and an increased reticulocyte count in peripheral blood.

Normal M:E ratio in marrow is 3:1. This ratio decreases in hemolytic anemias.
     (4) the retention by the body of the products of red cell destruction    (including iron, bilirubin, Hb )

Intravascular hemolysis

leads to :
  • Hemoglobinemia, hemoglobinuria
  • Hemosiderinuria
  • unconjugated hyperbilirubinemia and jaundice.
  • Haptoglobin levels are depleted

Extravascular hemolysis 

takes place within the macrophages of the spleen and liver.   Any reduction in red cell deformability leads to splenic sequestration, followed by phagocytosis.
  • not associated with hemoglobinemia and hemoglobinuria
  • often produces jaundice
  • can lead to the formation of gallstones ( pigment stones).
  • Haptoglobin levels are  decreased
  • splenomegaly.

Some of the hemolytic anemias are:






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